Our research focuses on understanding the pathogenesis of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH), the interaction between obstructive sleep apnea (OSA) and NASH, and the influence of NASH on lipid metabolism and cardiovascular risk factors.

NEWS

LINKS

Led by Kathleen Corey, MD, MPH, research in the lab for Clinical Investigations in Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH) at Massachusetts General Hospital focuses on lipid metabolism in patients with steatosis and steatohepatitis (the progressive form of fatty liver disease where the liver becomes inflamed due to fat accumulation).

Finding Biomarkers and Diagnostics for NAFLD and NASH

The increase in the incidence of obesity has played an important role in the increasing prevalence of NAFLD, the most common cause of liver disease in the United States. More than one-third of Americans and 400 million people worldwide have obesity.

Obesity, which results from the establishment and defense of an elevated fat mass in the body, is associated with more than 65 demonstrated comorbidities, or additional disorders, including diabetes mellitus, cardiovascular disease and several forms of cancer.

Obesity affects multiple metabolic functions of the liver. It is associated with the development of NAFLD-associated steatosis (the abnormal retention of lipids such as fat in the cell) and inflammation, and promotes the progression of several other liver diseases, including hepatitis C and alcoholic liver disease.

Our research is also focused on the development of non-invasive biomarkers for NAFLD. Our goal is to identify clinical and biological indicators that will allow us to diagnose and monitor fatty liver disease without the need for invasive procedures such as liver biopsy. Our group has identified several novel biomarkers of nonalcoholic steatohepatitis (NASH), including non-high-density lipoprotein cholesterol, and is currently evaluating several other promising markers.

Obstructive Sleep Apnea

We are also studying the interaction between obstructive sleep apnea (OSA)—the partial blockage of the upper airway during sleep—and fatty liver disease.

Like fatty liver disease, OSA impacts millions of Americans and carries serious health consequences. Evidence suggests that the chronic intermittent hypoxia (deprivation of oxygen) caused by OSA results in lipid peroxidation (the unnatural breakdown of lipids in the liver), as well as steatosis and steatohepatitis.

Our work has demonstrated that lipid peroxidation, reflected by oxidized phospholipids (OxPL), is increased in patients with NASH and decreases with NASH regression. Thus, lipid peroxidation appears to mechanistically link OSA and NAFLD. However, this link has yet to be evaluated in humans.

In addition, our work has identified the absence of OSA as a strong predictor of normal liver histology in obese patients who would otherwise be at high risk for NAFLD. This suggests that obesity alone may not be sufficient for the development of NAFLD but requires a second risk factor such as OSA.

Our group is currently working to evaluate lipid peroxidation in individuals with OSA and NAFLD and determine if OSA treatment can help NAFLD.